SC House Votes To “Sunset” Controversial Hospital Mandates

“CERTIFICATE OF NEED” PROGRAM COULD BE ON ITS DEATHBED … || By FITSNEWS ||  It’s an exceedingly rare day when this website finds occasion to praise members of the “Republican-controlled” S.C. General Assembly.  Typically they are good for little else than uncovering newer, more expensive ways to hold South Carolina back….


|| By FITSNEWS ||  It’s an exceedingly rare day when this website finds occasion to praise members of the “Republican-controlled” S.C. General Assembly.  Typically they are good for little else than uncovering newer, more expensive ways to hold South Carolina back.

Anyway, this week we can report on something good – a decision by the S.C. House of Representatives to eliminate the so-called “certificate of need” (CON) program.

This onerous, invasive program requires hospitals to demonstrate a market need prior to building new facilities, establishing certain new services, making certain capital expenditures or purchasing certain new equipment.  The idea behind forcing hospitals to obtain these certificates is to prevent duplication of services and – ostensibly – keep health care costs low.

We reject such government intervention on principle … and have consistently opposed this program as another example of taxpayer-subsidized meddling with the free market.

Anyway, by a vote of 103-1 the S.C. House has voted to do away with the program beginning in 2018 – although S.C. Rep. Jimmy Merrill, who led the push to do away with the program, says he’s fearful special interests will succeed in pushing back this “sunset” date.

S.C. Gov. Nikki Haley vetoed funding for the administration of the program last year, but her efforts were overruled by the S.C. Supreme Court.

Ironically, Haley was busted lobbying lawmakers in favor of a certificate of need while she was a member of the S.C. House of Representatives – and an overpaid fundraiser for Lexington Medical Center, the facility seeking the CON.  In fact Haley’s lobbying efforts were among the pieces of compelling evidence ignored by her former colleagues in a 2012 “show trial” in the S.C. House of Representatives.

Oh well …

Lawmakers are doing the right thing by getting rid of this program … assuming they stick to their guns and follow through on the 2018 deadline.


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Bible Thumper April 30, 2015 at 10:23 am

This is another good decision that is impossible to explain why.

One reason is that it reduces the need for hospitals to engage in corrupting lobbying.
It seems logical for government to decide if medical expenditures are needed, but pharmacies will build on 3 corners of one intersection. Seems wasteful, but the magic of the free market seems to make it work. It’s hard to recognize the harm of government planning except in extreme cases like Venezuela, but there is harm none the less.

RogueElephant April 30, 2015 at 10:30 am

You don’t think that just maybe they got a dose of free market capitalism do you ? NAW. LOL

Bill April 30, 2015 at 10:58 am

The program is controversial, as will be its elimination. The original purpose of the program was not to keep costs down, it was to keep quality up and to assure health care facilities were available to all areas of the state. The concern with all out competition, like the pharmacies mentioned by BT, was that if too many competing facilities were to locate in a given area, they could all go out of business leaving an area without adequate care facilities; or that all of the facilities would locate in the rich areas, leaving rural areas without health care; or that facilities would try to undercut each other by offering crap care and insurance companies would force their customers to use bad facilities to save the insurance company money. (of course we know that last thing won’t happen because insurance companies care about their customers.)
Our current system of health care finance probably eliminates some of those concerns. It will not be free market of course. We will be shifting these decisions to Blue Cross/Blue Shield and the other large insurers. No one will build a hospital or other previously regulated health care facility, unless they have an agreement with BCBS in advance; and BCBS will want a cut somehow. At least that is not bribery, I suppose.
That is not to say I oppose elimination of this program. It has become a corrupt program. Which is not surprising given who we have running this state.

Bible Thumper April 30, 2015 at 11:50 am

While healthcare is a different animal, competition doesn’t reduce quality. Quality is more likely to decline and costs go up when there is no competition driving down costs and enhancing service.

But I know with pure logic I can’t win this argument. Sometimes it’s profitable for some services to operate at a loss. Bi-lo may sell soda at a loss to get more people buying chips. I just think that hospitals can make better decisions than government. If a hospital doesn’t offer the most up to date services, other services the hospital offers suffer. It also effects their ability to recruit top quality physicians

Bill April 30, 2015 at 1:14 pm

Your argument is not pure logic. It shows a blind faith in the free market that not only is not supported by data, it ignores evidence, which is a component of a logical conclusions. To say competition never reduces quality, is untrue, ergo not logical.

Healthcare is not the same as cars. People must have health care to survive. The average person also has no way of judging the quality of the health care he is receiving; or whether the cost is reasonable. Nor do most people want to try to make those determinations. Who wants to shop for a brain surgeon? Everybody wants the best health care when their life of the life of their family member is at stake.

The pure free market will not result in greater quality of care for everyone. It will result in higher quality care for the wealthy, middle quality care for the middle and crappy or no care for the poor. If that is what we want fine. But to say the free market will make health care better for everyone is simply not true. If that is true why are people who live in western Europe, Canada, and Australia healthier and happier with their healthcare than Americans. The free market has never brought quality health care to the masses. It has always failed the poor and not so poor miserably.

Before Medicare, 50% of people over the age of 65 had no health insurance. They were limited to using charity wards in county hospitals for health care.

Before Medicare Part D, thousands of American Senior Citizens were going to Canada and Mexico to get drugs they could not afford int he US>

Sam April 30, 2015 at 12:27 pm

The CON regulation was created, as are many regulations, by big business with the express purpose to stymie competition in the market place. There is no such animal as a free market when government is used as a tool by the few to control their competitors. Take a closer look at how the system works.

nitrat May 1, 2015 at 9:44 am

There is no free market in any facet of the medical business including when you don’t have the opportunity to check prices and medical board complaints when you have had your heart attack and are in the ambulance on your to the hospital. that does so few heart procedures you don’t stand much of a chance.

Do you know any doctor or hospital that publically posts a fee schedule so that you can decide where you will get the best deal?

ted April 30, 2015 at 3:36 pm

What do you expect when you have an Asian as governor?

ELCID April 30, 2015 at 6:47 pm

Having served in the old Three Rivers Planning Commission which provided the Certificates of Need. I can tell you that it had an opportunity to help. But, as the only business man on the commission at the time, they had no idea of how to run a business.

Cost effectiveness was something that the other members had no clue about, or were just hiding their own personal agendas. Lexington Hospital was the worse one. It was only interested in duplicating services offered at other hospitals. Not providing anything else of value.

The number one thing needed was another Trauma Center. The entire Metro areas of Lexington, Richland, Fairfield and etc. only have one True Trauma Center: Richland Memorial. We’ve cost lives by not having another one in the area that closer to residents.

Lexington Hospital did not need a Heart Center for doctors to make money off the facilities paid for by Lex. residents. Partridge Hospital should never have been allowed to be built without a Trauma Center. Fountains, Paintings, Restaurants, and slick meeting places do not save lives.

Certificates of Need are necessary. Unfortunately, the commissions appointees are generally political hacks.

Hmmmm April 30, 2015 at 9:12 pm

“Certificates of Need are necessary. Unfortunately, the commissions
appointees are generally political hacks. So, now the citizens have no
protections, no additional Trauma Centers, and no real health system
that truly protects and provides for everyone.”

You make an odd argument. You admit the certificate of need system isn’t working, but blame it on self interested people….suggesting(like most liberals) that if only the RIGHT people were running the show it would all work better.

It’s seems a bit circular to me.

Maybe it’s the system itself that is the problem more than the people running it.


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